Stroke is a major cause of disability worldwide with approximately 800,000 new cases reported annually only in the United States, of which about 130,000 die. In the European Union stroke incidence appears to be markedly higher with over 460,000 deaths each year. The physical effects of stroke are variable and may include impairment in motor and sensory systems, language, perception, emotional and cognitive functions. Impairment of motor function usually involves paralysis or paresis of the muscles on the side of the body that is contralateral to the side of the brain lesion. People who have experienced a severe stroke often have significant impairment of muscle function of the arms, legs, and hands resulting in severe disability. Of all impairments that result from stroke, perhaps the most disabling is hemiparesis of the upper limbs. The upper limbs are of special concern because of the impact of upper extremity impairments on disability, independence, and quality of life. Consequently, improvement in motor abilities, and, more specifically, functional use of the upper extremity, is considered as one of the primary goals in post-stroke rehabilitation. However, even with rehabilitation, the functional recovery of arm and hand use is generally limited when compared with that of the lower extremities. Limited motor recovery in the paretic upper limb accounts indeed for a large share of the disabling sequels.
Traumatic brain injury as well as spinal cord injury require on-going, multiple disciplinary efforts to stabilize, decrease or prevent secondary impairments and complications and to improve or maintain social role functioning and quality of life for the individual throughout the remainder of the life. Because the average age at time of a spinal cord injury is 32, specialized care is necessarily long-term. Other types of diseases such as traumatic accidents and neurological disorders may result in similar deficiencies in strength, coordination and range of motion.
In order to recover or retain functional ability after a stroke or injury, patients undergo rehabilitation therapy, such as occupational and physical therapy.
Physical therapy with hands is still a main approach of therapy. However, the therapy with hands strongly relies on the physical therapist's personal experiences, and there is no means for accurately controlling the magnitude of applied force and the rotating extent of joint. Moreover one-to-one interaction between a therapist and a patient is limited in providing high intensity and high repetition training.
Robotic or interactive training is a new technology showing great potential for application in the field of neuro-rehabilitation. Robotic or interactive training has several advantages, e.g. adaptability, data collection, motivation, alleviation of patient safety concerns, and the ability to provide intensive individualized repetitive practice. Thus an objective of the present invention is to provide a device that may be used as a tool by a therapist whereby the therapist can assess the recovery of a patient and then utilize the present invention to assist the patient with the repetitive motions of the therapy.
Current robots usually show one degree of freedom or offer limited rehabilitation processes as they do not provide the range of motions needed for rehabilitation of multiple muscle groups.
U.S. Pat. No. 5,466,213 discloses an interactive robotic therapist which interacts with a patient to shape the motor skills. Said robotic therapist comprises a kinematic chain offering rotation/rotation movements. In use, said robot offers a limited rehabilitation surface—a 28 cm diameter circle only—due to its own kinematic chain.
US patent application 2012/0109025 relates to a robot for rehabilitation of the supination/pronation movements of the forearm and flexion/extension movements of the fingers. However, this device aims at rehabilitating complex movements such as grasping, and cannot be used as first-intention rehabilitation process.
According to the applicant, there is still a need for providing robots or interactive devices that can be used in first-intention rehabilitation processes and in later rehabilitation processes while also providing a large rehabilitation surface. Moreover, there is a need for providing an interactive device that can be used in rehabilitation as well as in quantitative assessment and monitoring.
Thus present invention aims at providing a large rectangular rehabilitation surface enabling full flexion/extension movements of the upper limbs (i.e. elbow and shoulder). To that end, the present invention comprises a H-shaped Cartesian coordinate planar interactive device including two motorized guiding mechanisms and one non-motorized guiding mechanism enabling, without interfering, motion of the limb of a subject through a large rehabilitation surface while minimizing the complexity, size, weight and cost of the interactive device.
Thus the present invention offers a large rehabilitation surface enabling rehabilitation and quantification of the patient recovery and progress thanks to an interactive device advantageously combining robotics and interactive environment to facilitate rehabilitation.